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Understanding One-year Mortality Rates and Comorbidity Burden in Older Adults Following Hip Fracture
Chris Sun1,2, Eric R Tecce1, Kimberly Dong1
1Rothman Orthopedic Institute, Philadelphia, Pennsylvania.
Insights
Hip fractures lead to significant mortality in older adults, with about 12% dying within one year. This study highlights the impact of age, sex, and comorbidities on hip fracture survival rates.
Area of Science:
- Geriatric Medicine
- Orthopedic Surgery
- Public Health
Background:
- Hip fractures are a major cause of morbidity and mortality in older adults.
- Global healthcare systems face substantial burdens due to hip fractures.
- 1-year mortality rates after hip fracture are high and variable.
Purpose of the Study:
- To evaluate 1-year mortality rates in older adults following hip fractures.
- To assess the effectiveness of contemporary orthogeriatric care strategies.
- To improve shared decision-making in hip fracture treatment.
Main Methods:
- Retrospective cohort study using the TriNetX Research Network.
- Inclusion of patients aged 65-90 with incident hip fractures.
- Calculation of 1-year all-cause mortality and Kaplan-Meier survival estimates.
Main Results:
- 1-year mortality rate was 11.6% among 197,222 patients.
- Mortality increased with age and was higher in men.
- Higher baseline comorbidity burden was observed in patients with 1-year mortality.
Conclusions:
- Approximately 12% of patients die within one year of a hip fracture.
- Multidisciplinary orthogeriatric models and postoperative care require continued optimization.
- Further improvements in outcomes and survival are achievable.
Background:
Hip fractures impose substantial patient morbidity and burden to health care systems globally, with potentially high and variable 1-year mortality rates. To improve shared decision making when guiding treatment for patients, this study evaluated 1-year mortality rates following hip fractures in the older adult population using a large multicenter live database. The study goal was to determine the recent 1-year mortality rate with contemporary orthogeriatric care strategies.
Materials And Methods:
A retrospective cohort study was conducted using the TriNetX Research Network. Patients aged 65 to 90 years with an incident hip fracture were identified, excluding those with same-day mortality or previous hip fractures. Cohorts were stratified by sex and 5-year age intervals. One-year all-cause mortality rates following hip fracture and Kaplan-Meier survival (KM) estimates, with log-rank tests, were calculated. Pre-fracture demographic and clinical characteristics were compared between those who succumbed within 1 year and those who survived beyond 1 year.
Results:
Among 197,222 included patients, the 1-year mortality rate was 11.6%, with an 86.7% KM estimate of survival. One-year mortality increased with age and was higher in men across all age strata. Patients with 1-year mortality demonstrated a higher baseline comorbidity burden, including neurocognitive, cardiovascular, metabolic, renal, hepatic, and pulmonary diseases and malignancies. Although women succumbing within 1 year had higher rates of certain neurocognitive and metabolic disorders, men had higher rates of chronic ischemic heart disease and chronic kidney disease.
Conclusion:
One-year mortality following hip fractures was approximately 12%. Continued monitoring and optimization of multidisciplinary orthogeriatric models and postoperative care may further improve outcomes and survival.
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